Did Not Attend (DNA) Policy

Overview

Are you aware that for every missed appointment, this could have been offered to another patient and will cost the NHS around £30.00 per appointment?

Policy Statement

The purpose of this policy is to provide guidance regarding the management of patients who failed to attend their appointments. It is essential to make the best use of the clinicians’ availability to ensure that all patients have access to appointments within an acceptable time frame.

This policy sets out the procedures for monitoring and recording, and the required actions to be taken to effectively manage missed appointments at Priory Medical Centre. Within general practice, failure to attend appointments is commonplace. It is therefore essential that an efficient management system is in place.

What is a DNA?

A DNA means that the patient neither attended their appointment nor advised the practice within 12 hours prior to the scheduled appointment that they are unable to attend. Advising the practice 12 hours prior to the appointments allows the practice time to cancel the appointment and offer to another patient.

The effects of DNA’s

The effects:

• An increase in waiting times for patients resulting in the risk of worsening patients’ health
• A waste of the organisation’s time – not simply the clinicians’ time but also that of the administration team as the appointment invariably needs to be rebooked
• Cost to the wider NHS in the requirement of additional clinicians
• Potential of risk to a child who is reliant upon an adult to ensure that they attend their appointment

Reduce DNA’s

If you’re unable to attend your appointment, please cancel as early as possible. This allows us to reallocate the slot to someone else who needs care.

You can cancel by:

• 📞 Calling 01926 293711
• 💻 Visiting: www.priorymed.nhs.uk/cancel-your-appointment
• 📱 Replying to your appointment reminder message
• 🚶 Speaking to us in person at reception

Managing DNA’s (our policy on how to deal with DNA’s)

• DNA 1
  • Should a patient fail to attend their appointment, the clinician or the clinical system will enter the fact that the appointment was missed and will record it as:
    • Did not attend – No reason given – SNOMED CT 270426007
  • It should be noted that, whilst unacceptable in most cases, there may be extenuating circumstances as to why the patient failed to attend their appointment.
  • Should there not be any mitigating reasons, then a letter/text message explaining the DNA will be sent to the patient.
• DNA 2
  • If the patient fails to attend a second appointment within a 12-month period, and should there be no reasonable mitigating circumstances, a further letter/text message will be sent to the patient.
• DNA 3
  • Should the patient then fail to attend a third appointment within the same 12-month period, a decision will be made by the Executive Director & Senior Partner as to whether the patient is to be removed from the practice list.
  • Prior to writing to the patient, the Senior Partner will assess whether removing the patient from the practice list would be detrimental to the patient’s health or wellbeing and cause significant harm. Should the decision be made to remove the patient from Priory Medical Centre, guidance from the BMA is to be reviewed.

Letters sent to patients are only valid for a 12-month period. These letters are to be saved in each patient’s electronic health record.

By reducing the number of DNAs, the organisation will:

• Enhance the efficiency of clinical sessions
• Reduce costs
• Increase productivity
• Offer a more effective service to patients
• Enable more effective booking of slots